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General NPI Number Information
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NPI Number | 1952949729
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Entity Type | Individual
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Provider Name | CAROLYN NIGHTINGALE RIKER MSN, CPNP-AC/PC
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Gender | Female
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 22 BRAMHALL ST
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City | PORTLAND
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State | ME
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Zip | 04102-3175
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Country | US
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Telephone | 207-662-2934
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Fax |
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Provider Business Mailing Address
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Address Line | 79 NONANTUM ST
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City | BOSTON
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State | MA
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Zip | 02135-2452
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Country | US
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Telephone | 207-469-5585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN2286242
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | CNP241619
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License Number State | ME
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